13.  Remarks
14. Certifies that the items identified above were manufactured in conformity to:
0 approved design data and are in condition for safe operation
0 non-approved design data specified in block 13
19.  0  Part 5.7.1.2 Release to Service
0 Other regulation specified in Block 13
Certifies that unless otherwise specified in block 13 (or attached), the work identified in Block 12 and described in block 13, above was accomplished in accordance with CAA airworthiness regulations and in respect to that work, the item(s) is (are) approved for return to service.
15. Authorised Signature:
16. Approval/ Authorisation Number 20. Authorised Signature 21. Approval/Certificate Number:
17. Name (Typed or Printed):
18. Date (dd/mm/yyyy): 17. Name (Typed or Printed):
23. Date (dd/mm/yyyy):
AMO CAA AAT (1/99)
FAA Order 8130.21G; FAA Form 8130-3
EASA 145, Appendix 1; EASA Form 1
TCCA Form 24-0078
Line-By-Line Instructions for Completion of Model AMO CAA Form AAT
(a) Block 1.  [STATE] (Pre-printed).
(b) Block 2.  Model CAA, Airworthiness Approval Tag, and Civil Aviation Administration (Pre-printed).
(c) Block 3.  System Tracking Reference Number.
(1) Fill in the unique number established by the CAA-approved numbering system.
(2) If the form is computer-generated, it may be produced as programmed by the computer.
NOTE:  Shippers must establish a numbering system for traceability in order to fill out block 3 of the form.  This system must also provide a means of cross-referencing the number(s) and product(s) being shipped.
(d) Block 4.  Organisation.
(1) Fill in the full name and address of the AMO or individual shipping the product(s)/part(s) as applicable:
(i) Company name and address.
(ii) Production Approval Holder (PAH) approval or certificate numbers as issued by the Authority of the State of Manufacturer, when applicable (e.g., production certificate number, approved maintenance organisation certificate numbers, air operator certificate number.
Note: Production certificates are issued to manufacturing companies by an Authority.  The MCARs presume that [STATE] will not be a State of Manufacturer or Design.  However, aircraft registered in State will likely be repaired, altered or rebuilt using parts and components exported from the State of Manufacturer.  Companies performing the repair, alteration, rebuild and export will be certificated by the State of Manufacturer as a production approval holder.  The PAH is required by the State of Manufacturer to use the airworthiness approval tag and certify their work in blocks 14 – 18 as described in this Part.   Consequently, States which will not be filling out block 14-18 will need to be familiar with all the uses of this form in order to properly accept parts and components. Production certificates are described in 14 CFR: 21, Subpart G.
(2) When a supplier has direct ship authorisation from a PAH, the following information should be entered:
(i) PAH name and address.
(ii) PAH approval or certificate number.
(iii) C/o Supplier name and address.
NOTE: If an individual product/part is produced as a spare by a supplier, the supplier must have either direct ship authority or hold a production approval (TSO authorisation) for all products/parts shipped.  If the supplier holds its own production approval, and the products/parts were manufactured and are being shipped under that approval, the information required in paragraph (1) above should be listed.
(e) Block 5.  Work Order, Contract, or Invoice Number.
(1) Fill in the contract, work order, or invoice number related to the shipment list, or maintenance release, and state the number of pages attached to the form, including dates, if applicable.  If the shipment list contains the information required in Blocks 6 through 12, the respective blocks may be left blank if an original, or true copy, of the list is attached to the form.  In this case, the following statement should be entered in Block 13:  "This is the certification statement for the products/parts listed on the attached document dated _________, containing pages ______ through ______."
(2) In addition, the shipment list must cross-reference the number located in Block 3.  The shipment list may contain more than one item; but it is the responsibility of the shipper to determine if the CAA of the importing jurisdiction will accept bulk shipments under a single Model CAA Form [AAT].  If the CAA does not permit bulk shipments under a single form, Blocks 6 through 12 of each form must be filled in for each product shipped.
(f) Block 6.  Item.  When Model CAA Form [AAT] is issued a single item number or multiple item numbers may be used for the same part number.  Multiple items should be numbered in sequence.  If a separate listing is used, enter "List Attached."
NOTE:  The blank form can be computer-generated.  However, the format cannot be changed, nor can any words be added or deleted.  Pre-printing of some information is permissible, i.e., the information in blocks 1, 2, 3, 4, and 19.  The size of blocks may be varied slightly, but the form must remain readily recognisable.  The form may also be reduced in overall size to facilitate placement of the wording on the back of the form onto the face of the document.
(g) Block 7.  Description.  Enter the name or description of the product/part as shown on the design data.  For products/parts that do not have design data available, the name as referenced in a part catalog, overhaul manual, etc., can be used.
(h) Block 8.  Part Number.  Enter each part number of the product.
(i) Block 9.  Eligibility.  State the aircraft, aircraft engine, or propeller make and model on which the parts manufacture approval is eligible for installation.  If a part is eligible for installation on more than one model, enter the words "to be verified by installer or TBV by installer." Where parts are TSO articles, state "TSO Article N/A" since eligibility for installation for TSO articles is determined at the time of installation.
NOTE: For TSO articles CAA Model Form [AAT] does not constitute authority to install a product on a particular aircraft, aircraft engine, or propeller.  The user or installer is responsible for confirming that the product is eligible for installation by reference to overhaul manuals, service bulletins, etc., as applicable.  While the information in Block 9 is optional, it should be filled out whenever possible.
(j) Block 10.  Quantity.  State the quantity of each product/part shipped.
(k) Block 11.  Serial/Batch Number.  State the serial number or equivalent (identified on the part) on the form for each product/part shipped.  If a serial number or equivalent is not required on the part, enter "N/A."
(l) Block 12.  Status/work.  Enter "Newly Overhauled" for those products that have not been operated or placed in service since overhaul.  Enter "PROTOTYPE" for products/parts submitted to support type certification programmes.  Other permissible/appropriate terms to describe the status of the product/part include: "INSPECTED", "REPAIRED," "REBUILT," or "ALTERED."
(m) Block 13.  Remarks.  Enter any information or references to support documentation necessary for the user or installer to make a final determination of airworthiness of the products/parts listed in Block 7.  Each statement must specify which item identified in Block 6 is related.  Examples of information to be supplied are as follows:
(1) Any restrictions (e.g., prototype only).
(2) Alternative approved part number.
(3) Compliance or non-compliance with airworthiness directives or service bulletins.
(4) Information on life-limited parts.
(5) Manufacturing, cure, or shelf-life data.
(6) Drawing and revision level.
(7) When used for conformity the word "CONFORMITY" must be entered in capital letters.  In addition, an explanation of the products/parts use, e.g., pending approved data, type certificate pending, for test only, etc., should be provided.  Information concerning a conformity inspection such as design data, revision level, date, project number.
(8) When used for spare parts, identify whether the parts are from the original manufacturer or another approved source and are made to the TSO.  In addition, if the Airworthiness Approval Tag [AAT] is for spare parts or sub components of a CAA approved replacement part, the TSO authorisation should be listed in Block 13.